Outline

The study on PAtient Satisfaction and Quality in Oncological Care (PASQOCÂ®) 2002 was the first assessment in Germany focussing directly on patient satisfaction in oncological care. In 2004 PASQOCÂ® was executed again, this time also focussing on breast cancer patients.

Method: To assess and observe quality of oncological ambulatory (out-patient) care, the formally validated questionnaire PASQOCÂ® was distributed to all cancer patients presenting at the investigators’ practices within a defined recruiting period. Inclusion criteria: German speaking, ≥18 years, confirmed cancer diagnosis, physical/mental ability to complete a self-administered questionnaire. Analysis of PASQOCÂ®: dichotomous 'problem scores' indicating presence/absence of a problem, with lower scores marking fewer problems (scale range: 0-100). Summed into 13 'dimension scores', each clustering a defined set of questions.

Results: The 49 practices recruited n=2617 women, 43.3 % with breast cancer (BCa); mean age with BCa: 59.9 years (others: 64.0 years; p≤0.001). Samples differed significantly in structure, eg. therapy goal, status of employment etc. WBCa reported on average more problems than WOT in all 13 dimensions but “communication with other patients”. Differences were highly significant (p≤0.01) for patient-physician relationship (WBCa: 10.6; WOT: 8.3), communication with physicians (21.6; 19.1), handling of side effects (41.4; 36.6), involvement of family members and friends (19.4; 15.3) and need for further information (21.4; 18.9). WBCa showed particular concern in respect to information on impact on sexual life (42.7; 37.0) as well as consideration of family situation (21.5; 17.0). Furthermore, WBCa reported a greater need for information on therapy related side-effects. There is evidence that WBCa age 40≤49 report more problems compared to WOT than other age groups as do WBCa with chemo-/radiotherapy.

Conclusion: The PASQOCÂ® questionnaire is a tool to detect differences in patient perception of quality of care in defined patient populations. Based on the hypothesis that all female cancer patients are cared for in the same way, we can conclude that WBCa perceive some of those services provided by professional care givers as more inefficient and are less satisfied than WOT (and vice versa). The next step is to identify levers and develop means of action for all women suffering from cancer.